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Surgical Endoscopy

, Volume 31, Issue 10, pp 3890–3897 | Cite as

Midterm follow-up of a randomized trial of open surgery versus laparoscopic surgery in elderly patients with colorectal cancer

  • Atsushi IshibeEmail author
  • Mitsuyoshi Ota
  • Shoichi Fujii
  • Yusuke Suwa
  • Shinsuke Suzuki
  • Hirokazu Suwa
  • Masashi Momiyama
  • Jun Watanabe
  • Kazuteru Watanabe
  • Masataka Taguri
  • Chikara Kunisaki
  • Itaru Endo
Article

Abstract

Background

Laparoscopic surgery has been widely accepted for the treatment of colorectal cancer; however, long-term outcomes in elderly patients remain controversial. The midterm results of a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer are presented.

Methods

This was a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer. The primary outcome was complication rate, and secondary outcomes included 3-year recurrence-free survival and overall survival. A total of 200 patients were randomly assigned to open surgery or laparoscopic surgery between 2008 and 2012. The main study objective was to compare the midterm outcomes of open surgery with those of laparoscopic surgery in elderly patients with colorectal cancer. This trial is registered with Clinical Trials.gov (NCT01862562).

Results

There were no differences between the laparoscopic surgery group and open surgery group in the 3-year overall survival rate (91.5% for laparoscopic surgery vs. 90.6% for open surgery, p = 0.638) or the 3-year recurrence-free survival rate (84.8% for laparoscopic surgery vs. 88.2% for open surgery, p = 0.324). The local recurrence rate was significantly higher in the laparoscopic surgery group than in the open surgery group in rectal cancer (13.8% for laparoscopic surgery vs. 0% for open surgery, p = 0.038). In subgroup analysis according to tumor location, there were no significant differences in the 3-year overall survival rate or 3-year recurrence-free survival rate between the two treatment groups.

Conclusion

The midterm outcomes of laparoscopic surgery are similar to those of open surgery in elderly patients with colorectal cancer.

Keywords

Laparoscopic surgery Elderly patient Colorectal cancer Randomized study 

Notes

Author contributions

Ishibe Atsushi and Fujii Shoichi contributed to the study conception and design. Ota Mitsuyoshi, Yusuke Suwa, Shinsuke Suzuki, Hirokazu Suwa, Jun Watanabe, and Kazuteru Watanabe contributed to data acquisition. Ishibe A contributed to data analysis, interpretation, and writing the report. Masataka Taguri contributed to statistical analysis. Chikara Kunisaki and Itaru Endo contributed to editing, reviewing, and final approval of the report.

Compliance with ethical standards

Disclosure

Drs. Atsushi Ishibe, Mitsuyoshi Ota, Shoichi Fujii, Yusuke Suwa, Hirokazu Suwa, Masashi Momiyama, Jun Watanabe, Kazuteru Watanabe, Masataka Taguri, Chikara Kunisaki, and Itaru Endo have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Atsushi Ishibe
    • 1
    Email author
  • Mitsuyoshi Ota
    • 2
  • Shoichi Fujii
    • 2
  • Yusuke Suwa
    • 1
    • 2
    • 3
  • Shinsuke Suzuki
    • 1
    • 2
    • 3
  • Hirokazu Suwa
    • 1
    • 2
    • 3
  • Masashi Momiyama
    • 1
  • Jun Watanabe
    • 1
  • Kazuteru Watanabe
    • 1
  • Masataka Taguri
    • 3
  • Chikara Kunisaki
    • 2
  • Itaru Endo
    • 1
  1. 1.Department of Gastroenterological SurgeryYokohama City UniversityYokohamaJapan
  2. 2.Department of Surgery, Gastroenterological Center, Graduate School of MedicineYokohama City UniversityYokohamaJapan
  3. 3.Department of Biostatistics, Graduate School of MedicineYokohama City UniversityYokohamaJapan

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